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Case Reports
. 2023 Feb 15;7(4):125-128.
doi: 10.1016/j.case.2022.11.009. eCollection 2023 Apr.

Aortic Valve Fenestrations: An Unsuspected Cause of Severe Regurgitation

Sahithi Sharma  1 , Anand Reddy Maligireddy  1 , Minako Katayama  1 , Christopher B Kendall  1 , Hari P Chaliki  1
Affiliations
Case Reports

Aortic Valve Fenestrations: An Unsuspected Cause of Severe Regurgitation

Sahithi Sharma et al. CASE (Phila). .
No abstract available

Keywords: Aortic regurgitation; Aortic valve fenestrations; Doppler imaging; Echocardiography.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Echocardiographic images. (A) Two-dimensional TTE zoomed apical 3-chamber view without (left) and with (right) color flow Doppler, demonstrates AR with flow convergence. The AR jet severity is difficult to quantify because of the jet eccentricity. (B) Two-dimensional TEE, midesophageal level, zoomed short-axis view (80°) of the aortic valve without (left) and with (right) color flow Doppler, demonstrates that the AR originates between the noncoronary and left coronary cusps. (C) Two-dimensional TEE, midesophageal level, zoomed long-axis view (137°) with color flow Doppler, demonstrates an eccentric AR jet directed toward the LV septum with a proximal flow convergence. (D) Two-dimensional TEE, midesophageal level, zoomed long-axis view (137°) with color flow Doppler, baseline color scale shifted down to 37.7 cm/sec, demonstrates a proximal isovelocity surface area radius r = 0.71 cm. (E) Continuous-wave Doppler spectrum of the AR jet demonstrates a maximal regurgitant velocity of 4.1 m/sec and regurgitant time-velocity integral of 264.0 cm. The calculated effective regurgitant orifice area is 0.29 cm2; RV is 77 mL.
Figure 2
Figure 2
Intraoperative surgical findings. (A) Trileaflet aortic valve visualized during surgery focused on the noncoronary cusp (arrow). (B) The yellow box surrounds the zoomed view of the noncoronary cusp of the aortic valve. (C) Close-up image of the noncoronary cusp reveals multiple fenestrations (arrows).
See this image and copyright information in PMC

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